Evaluation of Diabetes Self-Management Consultant CareThe overall objective of this study is to develop, implement and evaluate the effectiveness of a collaborative care intervention to improve blood glucose control and diabetes-related quality of life for subjects with type 2 diabetes being cared for in two different health care systems. The effectiveness of their diabetes Self Management Consultant (SMC) Collaborative Care intervention will be evaluated by comparing it with a randomized usual care control group for subjects with type 2 diabetes.Specific Aims 1. Develop a diabetes Self-Management Consultant (SMC) intervention designed to improve blood glucose control and diabetes-related quality of life for adults with type 2 diabetes. 2. Recruit SMCs, Primary Care Physicians (PCP)s, and subjects for the study. 3. Pilot test the feasibility of all major elements of the SMC intervention including data collection and self-management consultant protocols and activities with a small number of subjects. 4. Implement the intervention in both the Detroit Department of Health and the University of Michigan Department of Family Medicine. 5. Conduct a randomized clinical trial to evaluate the relative effectiveness of the SMC intervention compared to usual care in improving blood glucose control and diabetes-related quality of life. 6. Identify variables (e.g., program site, demographic, psychosocial, resource, and health) that predict which subjects benefit from participating in the SMC intervention. 7. Estimate the cost-effectiveness of the SMC intervention, relative to the cost of usual care, in the short-term, from the perspective of the health care insurer. 8. Estimate the expected effect the SMC intervention has on end-stage subject outcomes (both microvascular and macrovascular complications) and long-term costs through the use of Monte Carlo simulation models. 9. Disseminate the results, materials, and protocols developed for this study, nationally, and provide training and technical assistance to health care professionals who wish to use the SMC intervention (or parts of it) in local settings.HypothesisThe SMC intervention will be more effective than usual care in improving blood glucose control and diabetes-related quality of life.